MEDICARE: DR. GARY Y YANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	221882	NY
2	2085R0001X	Radiation Oncology Physician	A77188	CA

General Provider Information

NPI Number	:	1447231915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY Y YANG MD

Provider Business Mailing Address
First Line	:	11234 ANDERSON STREET
Second Line	:	SUITE B-121
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11234 ANDERSON ST
Second Line	:	SUITE B-121
City	:	LOMA LINDA
State	:	CA
Zip	:	92354-2804
Country	:	US
Telephone Number	:	909-558-4244
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/21/2010

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